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USIJurgy

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  1. USIJurgy replied to LadyTiger44's topic in Travel
    I've worked here at Yale since January- I am at a satellite facility. I have really liked the assignment. Keep in mind Yale has a contract with NursesRx, which is owned by American Mobile. So, if you arent working for an American Mobile company your pay rate will be lower (your company will have to skim some off the top from what Yale pay's NursesRx who pays your company who pays you.) The orientation was pretty thorough for a traveler- 12 hours of hospital orientation, 8 hours of computer training, 16 hours on the floor. Parking is around $300 a contract so make sure that is in your contract. Also, you have to wear royal blue scrubs- nothing else- so you might want a little money for that. If you take the company housing AM puts you up in Stony Brook Apartments in East Haven. I have always felt safe and the neighborhood is quiet. I am definitely looking forward to the pool opening up this summer! Good luck!
  2. They can play opossum all they want- no reason to shove ammonia in their face. A trick we use to determine if someone is "faking" is to place their arm above their head, bend their elbow and have their hand in front of their face. Once you let go of the arm gravity should do it's job and their hand should hit their face. If the hand, after multiple attepts, continues to fall above their head or below their face it is a good indicator that they have voluntary muscle control- who wants to hit themselves in the face?!
  3. Hmmmm. I don't know these abbreviations but if I had to take a guess.....youre wanting to get a medically sterile urine sample from an indwelling catheter? I don't think it is possible to get a totally sterile specimen without taking out the catheter and replacing it with a new one and getting a sample then. I suppose it would be possible to clamp the catheter distal to the sampling port, clean it well, then draw your specimen from there. I don't think it would be even close to sterile if you get it from the drainage bag.
  4. Our door to CT time is 20 minutes. There is no delay for IV or EKG (unless an unsafe rhythym is identified once the patient is placed on a portable monitor). It is OK for an RN to activate the stroke code and transport to CT with ACLS meds and equipment as long as the patient has no seizure history and has a stable blood glucose if the MD is not at the bedside within 10 minutes of presentation. CT results should be availble within 30 minutes and thrombolytic therapy should begin within one hour of presentation. I work in a 60,000 visit per year ER. We activate a stroke code for any patient presenting with a positive Cincinnati scale (droop, drift, or slurred speech) within 8 hours of arrival (even though IV thrombolytic therapy can only be given within 3 [i think thats the new guideline] hours of onset of symptoms). Just because they arent eligible for IV tPA doesn't mean they aren't eligible for Merci Clot Retrieval or something similar. Patients who wake up with the symptoms are not considered stroke codes because you don't know the actual onset. A good question to ask family is "When was the last time you saw him normal?" Hope this helps!
  5. As the charge nurse your job is to "man the ship." Typically charge should assign patients to nurses either on a round-robin basis or an acuity basis. Charge should also be responsible for getting a provider to the bedside for the patient who is actively dieing. He or she should also be a resource for all the nurses working i.e.- if no one else can get an IV on somebody your charge nurse should be someone who can get an IV on the diabetic renal hypotensive one-armed patient without batting an eye. Most hospitals have a triagen nurse to do just that: triage. The triage nurse shouldn't also be responsible for having a patient assignment as they are technically responsible for every patient in the waiting room and at a minimum should be performing "across-the-room assessments" (thats in the ENA core curriculum, I didn't make it up!). There is no way someone could be checking in every front door patient, every EMS patient, supervising a waiting room, and actively providing care for a patient load. Well, I suppose it is possible but I dont think it is safe. My facility uses 1 triage nurse, 1 ambulance triage nurse, and 1 charge nurse. If staffing/acuity is low the charge nurse may also act as ambulance triage. If staffing is REALLY low then a manager will cover charge so that the charge can cover the triage nurses break.
  6. USIJurgy replied to wanderlust99's topic in Travel
    Mine took a little under a month but I was waiting a long time for verification from California.
  7. Thats awesome! I would love to travel with a large group. I am an ER nurse, just started an assignment in CT but would like to go to California again (I did the bay area and had a blast.)
  8. USIJurgy replied to wanderlust99's topic in Travel
    I took my third travel assignment in NYC and ended up staying in the city for 2 years! While I came to conclusion NYC was not for me, travel nursing is perfect for giving the city a shot- you dont have to pay ridiculous rent prices, everything is set up for you! I started as a traveler at Lenox Hill on the Upper East Side then became full-time. They dont have travelers in their ER any more but I hear there are still some up in CTICU. I know some hospitals require a BSN for travelers (NYU). Also, for your first NYC experience I would insist on a hospital in Manhattan. You should also insist on a building with a doorman. The first building they put me in was a fifth-floor walk up with no doorman and it was craaaaazy old. I complained and they moved me into an excellent place on East 51st between 1st and 2nd. I travled with American Mobile. Good luck!
  9. My first job was at Kaiser Walnut Creek. I showed up on the first day and they said, "Who are you? Youre a nurse? Youre working here? Oh, ok, go follow her." So yes, stay away from Kaiser hospitals for at least your first assignment. Califronia is a great place to go for your first assignment (mandated ratios). I found it easiest to fly into Sacramento and get my license and all that in person instead of trying to do it all through mail. Good Luck!
  10. While I cant speak to the severity of pain associated with an ovarian cyst; As an ER nurse I can speak to the slightly inflammed appendix. In my ER the surgeons are not quick to operate on an otherwise healthy individual who has a normal white count and no fever. In these situations we do usually send the patient home with instructions to come back in 24 hours if they develop fever or increased pain. We would never send someone home who didn't have their pain and nausea under control first. As for the lack of education provided to your husband and daughter regarding lab tests and all the different treatment options- it sounds like both the ER nurse and ER MD could have done a better job. While 1 in 3 patients who aren't admitted go home from an ER without a definitive diagnosis, a patient should never leave wondering if everything was considered. I hope this helps!
  11. What I was saying was that if I was going to only be in New York City for 13 weeks, I would want to live in the thick of it all- Manhattan- not 45 minutes away from the night life of NYC on the north side of the Bronx if I was doing a travel assignment.
  12. I worked an ER contract at Kaiser Walnut Creek and there was many a shift where the only people who weren't travelers were charge and the two triage nurses. While it was nice knowing that all of the people you were working with would help you out- it did become a little bit difficult to figure out some of their whacky protocols!
  13. I am currently at Lenox Hill on the upper east side and it is great. I would recommend the ER to anyone for sure. The housing was a bit rough at first (think smelly smokey apartment in prewar building) but then I got moved to a great place with a doorman and an elevator and couldnt have been happier! I have hear good things about Bellevue if you loooooove trauma. Also, I really wouldn't recommend going to the Bronx, Brooklyn, or Queens. I figured if I am going to travel to NYC then I want to be in the city not a burrough!
  14. Definitely avoid Kaiser at all costs- ESPECIALLY for your first travel assignment. I took my first travel job at Kaiser Walnut Creek in the bay area in the ER and it was a nightmare. It was terrible working a 12 hour shift while all the other nurses were working 8 hour shifts- you would get shifted around- having to take report on brand new patients multiple times. The ER was terrible for many other reasons but I am sure it is just at WC and not every Kaiser ER. However, Kaiser is notorious for being management top heavy and that presence is constantly felt while working there. There is always something new coming down the pipeline that just gets piled onto the nurses. Isnt it interesting that we are all expected to do all the new tasks, while no task is every taken away?
  15. USIJurgy replied to tinyfeet28's topic in Travel
    My company paid for my rental car for 2 of the 3 travel assignments I did in California. I still made over $30 an hour and had private housing in a 1 bedroom apartment. Don't settle for anything less! While I love working with my recruiter and think she is great- it is important to remember that if you don't work, they don't make money! I always picture her as a used-car-salesman trying to drive a hard bargain =)

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